Hiatal Hernia
A hiatal hernia is an abnormality in which a portion of the esophagus or stomach protrudes from inside the abdomen, through an opening in the diaphragm muscles, up into the chest. The esophagus is a tubular structure that extends from the back of the throat through the central portion of the chest, down through an opening in the diaphragm muscles that separate the chest from the abdomen, and attaches to the stomach in the abdomen. The inner layer of the esophagus, the mucosa, is a smooth thin layer that produces a small amount of mucous to help swallowed food be propelled down the esophagus into the stomach with less friction during swallowing. These cells of the inner lining are sensitive to acid. The middle layer which is the functionally important layer is comprised solely of muscle. It is the contraction of this muscle layer that propels food from the throat down the esophagus into the stomach (swallowing). The terminal 2-3 inches of this muscle layer ends down by the stomach and functions as a valve that keeps contents of the stomach from coming back up into the esophagus. This area of muscle relaxes only when swallowed food reaches the end of the esophagus, or during vomiting.
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